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What are the medical causes of low libido?

06 June 2019 in Health

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Losing your libido can be challenging, particularly if it happens suddenly or continues unabated for a long period of time. People often find that losing their sex drive puts pressure on personal relationships, damages their self-esteem, and reduces their overall sense of wellbeing - leaving them feeling unhappy or unfulfilled.

Low sex drive is a surprisingly common issue. The sensitive (and often embarrassing) nature of the problem means that a lot of cases go unreported, but a global study of sexual attitudes and behaviours has shown that low sex drive affects between one and 20% of adult men and between 26 and 43% of adult women.

Many people assume that low (or reduced) sex drive is normally a consequence of the aging process, and it’s true that getting older can alter hormone levels in your body, triggering a natural decrease in your libido. But your sex drive can change at any time; low libido is associated with a variety of different causes, including psychological and medical issues that can affect you at any age.

Relationship problems, low self-esteem, and work-related stress can all have a profound impact on your sex drive, as can smoking, drinking too much, or gaining weight over a short period of time.

Loss of libido is also associated with a number of underlying medical conditions, including diabetes, cancer, cirrhosis of the liver, heart disease, depression and hormonal imbalances.

Birth control pills, antidepressants, and other medications can reduce your sex drive. There is evidence to suggest that using antihypertensive medications like spironolactone, amiloride, and triamterene may reduce your libido too.

In this article, we’ll walk you through the main medical causes of low sex drive, exploring some of the common and uncommon triggers to help you understand why your libido may have changed. You’ll also find self-care advice to help you tackle low or reduced sex drive while you are trying to rule out the existence of an underlying medical condition.

When to worry

Everyone’s sex drive is different. Some people simply need more (or less) sex than others, and there is no such thing as a ‘normal’ libido. It is normal to lose interest in sex for short periods of time, particularly if you are feeling stressed, overworked or anxious.

That said, you should always talk to your doctor if:

  • you notice a sudden decrease in your libido
  • your libido has been lower than normal for an extended period of time
  • low sex drive is having a negative impact on your relationship(s)
  • loss of libido is lowering your self-esteem or affecting your general sense of wellbeing

In many cases, low libido is caused by a psychological issue like stress, low self-esteem or a lack of intimacy between partners. But as reduced libido can be a symptom of some serious medical conditions, it is worth ruling out these issues before you start investigating the psychological causes of low libido.

What are the common medical causes of low libido?

The menopause

The menopause is a natural part of the aging process that occurs when a woman’s ovaries stop producing eggs. The menopause alters the balance of hormones like estrogen and progesterone in your body and is often associated with symptoms like hot flushes, fatigue or anxiety.

The menopause is associated with a decrease in sexual desire, and studies show that up to 40% of women report loss of libido while going through the menopause. At present, doctors cannot be sure whether this loss of libido is directly linked to the fluctuation of estrogen and other hormones in the body, or whether it’s a secondary side effect of symptoms like fatigue or anxiety. The menopause can cause the vagina to become dry and irritated, which may make intercourse less enjoyable and reduce your desire to engage in sexual activity.

If you think you may be experiencing menopausal symptoms, and feel this may be contributing to a lower libidio, you can always see a doctor for more information. You can also read some tips on coping with the menopause.

Low testosterone

Testosterone is a hormone that is closely linked to sexual arousal in both men and women. Several in-depth studies have shown that low levels of testosterone are strongly associated with reduced sex drive or low libido, especially in men aged 40-79.

Your testosterone levels gradually decline as you age, which may explain why low libido appears to be more common in older populations. However, testosterone levels can also drop as a result of conditions like hypogonadism, where the testicles or ovaries stop functioning correctly.

Hypogonadism can be related to an underlying medical condition like Klinefelter's syndrome or Turner syndrome. Hypogonadism can also develop as a result of conditions like mumps or an autoimmune condition like Addison’s disease.

Your testosterone levels can be affected by weight gain, injury to the testicles, infection, and certain cancer treatments. Fortunately low testosterone can be treated with testosterone replacement therapy, and you may be able to address some of the symptoms - including low libido - by making changes to your diet or lifestyle. See your doctor if you are worried about low testosterone levels.

Hormonal contraceptives

Hormonal contraceptives like the combined pill, the patch, or the contraceptive implant alter the normal balance of hormones in your body.

Because hormones like oestrogen are responsible for regulating sexual function, some women may find that using hormonal contraceptives reduces their sex drive. One study, which looked at 1,938 American women, found that more than one in five (23.9%) of participants experienced some loss of libido once they started taking a hormonal contraceptive, although other studies that focused on implants and other forms of hormonal birth control suggest that 5-15% may be a more realistic figure.

If you are taking a hormonal contraceptive and you notice a change in your libido, you should talk to your doctor straight away. They may be able to help you switch to a different form of contraception or provide advice on coping with the change. You can also read more about the different types of contraception.

Prescription medications

Certain prescription drugs have been shown to cause low libido. This includes some of the medications used to treat high blood pressure - including methyldopa, clonidine and spironolactone - the selective serotonin uptake inhibitors (SSRIs) used to treat depression and some antipsychotic medications.

Some of these drugs may alter blood flow to the genitals, which makes it hard to maintain an erection, and may lower your interest in sex. Others may directly alter your brain chemistry, which reduces the level of testosterone in your system and causes a corresponding reduction in sex drive.

The good news is that your doctor may be able to switch your medication and prescribe something that doesn't affect your libido. They may prescribe medications that are designed to counteract reduced blood flow to the genitals and alleviate some of the side effects.

Type 2 diabetes

Low libido and reduced sexual function are both common side effects of type 2 diabetes. An Iranian study that examined sexual function in 110 diabetic women found that 53% of participants struggled with low sex drive. A similar study that investigated sexual function in diabetic men living in Iraq found a ‘significant correlation’ between type 2 diabetes and male sexual dysfunction.

Type 2 diabetes causes damage to the blood vessels, which can reduce blood flow to the genitals and make intercourse difficult or painful. Type 2 diabetes also affects the balance of hormones in your body, which could prevent arousal or decrease your libido by suppressing the release of testosterone in the brain.

Learning how to manage your diabetes can help to restore proper sexual function. This may mean adjusting your diet and lifestyle, or taking a medication like a sulfonylurea. Your doctor may prescribe a medication that helps to tackle sexual dysfunction directly, particularly if your low libido is a consequence of erectile dysfunction.

Depression and anxiety

Depression, anxiety and other mental health disorders are closely linked to low libido. A recent study published in the Indian Journal of Psychiatry found that approximately 62% of depressed males struggled with some form of sexual dysfunction, and an in-depth review of several similar studies suggests that depression, anxiety and other mental disorders are associated with reduced libido.

The exact reasons for this link are not properly understood, but depression and anxiety are serious medical conditions that can affect every aspect of your life. People suffering from depression often find that they feel lethargic, tired or hopeless, which diminishes their interest in sex. People with depression also experience difficulties communicating with people they love, which may decrease the opportunities for intimacy and leave them feeling cut off from their partners.

Some depression medications may also affect libido.

If you think you might be suffering from a serious mental health issue, see a doctor as soon as you can. Read more about tackling depression.

Heart disease and other chronic illnesses

Chronic diseases like heart disease, arthritis, or cancer can put a lot of strain on your body, reducing your energy levels and leaving you feeling worn out or exhausted. According to the American Association of Sexuality Educators, Counselors and Therapists (AASECT), the high levels of fatigue caused by chronic illness often have a detrimental impact on your interest in sex, and are frequently associated with low libido.

Some chronic diseases can interfere with the way your nerves or blood vessels function, and may cause pain that makes intercourse difficult or undesirable. Certain medications - including some cancer treatments, and the medications prescribed for heart disease - may also lower libido.

If you are suffering from a chronic illness and notice a drop in your libido, book an appointment with your doctor. They may be able to help you explore alternative medications, or connect you with a counselling service that can help you work through this difficult time.

You can also read some tips on coping with a chronic illness.

Other forms of sexual dysfunction

If you are suffering from another form of sexual dysfunction, sex can become difficult or stressful. Over time, this can reduce your desire for sex and make sex unfulfilling, which may have a negative impact on your llibido. Erectile dysfunction, premature ejaculation, vaginal dryness, and pain during sex can all reduce your sex drive.

If you are suffering from another form of sexual dysfunction and find that your libido has decreased as a result, talk to your doctor. They may be able to help you treat the underlying cause, provide support and advice on how to cope with sexual dysfunction, and suggest strategies for coping with your situation.

What are the less common medical causes of low libido?

Obstructive sleep apnea

Obstructive sleep apnoea (OSA) is a sleep disorder in which a person frequently stops breathing during sleep, usually as a result of the muscles in the throat relaxing, and the upper airways becoming blocked.

Because OSA causes fragmented sleep, the condition is frequently associated with daytime sleepiness and fatigue. OSA can also disrupt your body’s natural hormone cycles, which may have a negative impact on your sex drive.

According to a study published in Sleep Medicine, approximately 23% of men suffering from OSA report low or reduced libido. A similar study published in The Journal of Sexual Medicine indicates that women with OSA are also more likely to experience reduced sex drive.

Sleep apnoea is normally treated with a continuous positive airway pressure device (or CPAP mask), a breathing apparatus that pushes a steady flow of air into the airway to help keep it open during sleep. If you think you might be suffering from OSA, visit your doctor.

Hypothyroidism and other hormonal imbalances

As sexual desire is tied to the presence of certain hormones, a hormonal imbalance like hypothyroidism can sometimes cause low libido. Hypothyroidism is an uncommon condition that occurs when your thyroid gland stops producing certain hormones. Common signs of an underactive thyroid are tiredness, weight gain and feeling depressed, but studies show that low sex drive is a relatively common sympton.

One study - conducted in 2019 - suggests that between 59 and 63% of men with hypothyroidism struggle with some form of sexual dysfunction. The association is weaker in females, but the same study found that between 22 and 46% of women with hypothyroidism also reported some form of sexual dysfunction.

An underactive thyroid can be easily treated by taking hormone tablets to replace the hormones your thyroid isn't making. If you think you might be suffering from hypothyroidism or another hormone disorder, you should visit your doctor. They’ll be able to help you diagnose your symptoms.

Studies show that treating a hormone disorder with the correct medication can have a positive impact on your libido, but people suffering from a hormonal disorder may also find therapy useful, particularly if you are struggling to cope with the effects of low libido.

How is low libido treated?

Treatment for low libido varies according to the cause. If your libido has dropped as a result of anxiety, depression or another - equally serious - mental health issue, your doctor may be able to treat the underlying condition with a combination of prescription medications, counselling or therapy.

If your low libido is a result of a heart disease or another systemic illness like diabetes, your doctor may be able to alleviate your symptoms by treating any disease or illness first, or providing additional therapies that can increase your sex drive. You should always seek medical attention if you think your libido may have dropped as a result of a serious medical condition.

Testosterone treatments are available for men who suffer from hypogonadism. Women going through the menopause may be able to access hormone replacement therapy (HRT) that will address reduced libido.

If you think you might be suffering from hormonal imbalance, explore your options with your doctor. They will be able to make an informed decision about whether hormonal replacement therapies are right for you.

What about the O-shot, clitoral therapy or flibanserin?

In recent years, drug companies have started marketing a number of new therapies that claim to increase sexual desire and reverse low sex drive. This includes injections, special therapy tools, and medications like flibanserin, which is often marketed as a cure for low libido.

These treatments are new, so we do not have the data needed to determine their effectiveness in treating low sex drive. Some of these therapies may have harmful side effects, so always check with your doctor before you start exploring options like this.

Low libido caused by chronic pain may be treated with prescription painkillers, cognitive behavioural therapy (CBT) or counselling, and low libido that’s a result of pregnancy or post-surgical pain can also be treated this way.

Low libido that is caused by a medication like methyldopa can be harder to treat, but you should still talk to your doctor. They may be able to switch you across to a different medication or refer you to a therapist.

Note: You should always consult with your doctor before you stop taking a prescription medication. Some prescription medications can have adverse effects if you stop taking them completely and you may be putting your health at risk.

What can I do to manage low libido?

There are a few things you can do to help manage low libido on your own. These include:

Following a healthy diet

Maintain a healthy, balanced diet and lifestyle by:

  • cutting down on junk food or foods high in sugar
  • eating more fruit and vegetables
  • eating more whole grain foods like brown pasta or brown rice
  • exercising for at least 150 minutes per week
  • drinking more water
  • making sure you’re eating regular meals to reduce the temptation to snack

The idea that eating certain foods can boost your libido and/or increase the level of testosterone in your body is popular, but there is no evidence to suggest that eating certain foods can boost or improve your libido.

Relationship counseling

Regardless of the cause, low libido can put a strain on your relationship(s) and may create conflict between you and your partner. The extra pressure caused by this conflict may further reduce your libido, so it’s important to talk to your partner and engage in an open discussion about your sex drive.

If you’re struggling to talk to your partner, counselling for couples or sex therapy can be useful. These services will allow you to talk about any difficulties in a safe and relaxing environment.

Relationship counselling may help you to find coping mechanisms for some of the issues caused by low libido, and may help you tackle any underlying causes, particularly if your low libido is linked to a psychological problem. Your doctor should be able to put you in touch with a counselling service.

Reducing stress and anxiety

Losing your libido can be stressful, and you may find that dealing with this makes you feel anxious, unsettled or depressed. Unfortunately stress, depression and anxiety can further reduce your interest in sex. Worrying about your lack of sex drive may even make the problem worse.

Therapy can encourage you to address negative thoughts about your sex drive, and help you tackle any problems with self-esteem. Therapy may also help to tackle the secondary causes of low libido, such as depression and anxiety.

You could approach your doctor and ask them to refer you to a therapy service, or you could try cognitive behavioural therapy (CBT). CBT is designed to help you stop negative thinking patterns, which can change the way you feel about situations and the way your body responds to scenarios that you find stressful or hard to manage.

CBT can be delivered in different ways. It can be done one-on-one, in a group, or through a self-help book. You can even use an online service from the privacy of your own home, and for this, try Braive.

Braive offer a range of online courses designed to help you manage anxiety and stress. Most of these courses use live illustration videos to pass on important skills and methods for dealing with stressful situations. This can prove useful if you’re struggling with performance anxiety.

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Conclusion

Low libido is a common problem, and it can be triggered by a variety of different conditions. Lifestyle issues like work stress can play a role, but there are several medical causes too, and it’s important to rule out these triggers as soon as you can.

Diabetes, chronic conditions like cirrhosis of the liver, some prescription medications, depression, hormonal imbalances and sexual dysfunction can all affect your sex drive, while other serious medical conditions - like depression - are also associated with low libido. If you think you might be suffering from one of these conditions, book an appointment with your doctor so they can diagnose your condition and prescribe appropriate treatment.

There may also be some things you can do to manage low libido on your own, including making changes to your diet and lifestyle, or accessing therapy services. But you should always seek medical advice first.

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Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.